Early inpatient rehabilitation therapy has been known to have beneficial impact on physical function and mobility, psychological status and cognitive function of patients following an acute medical event requiring hospitalisation.1 Following an acute hospital care, those who have been identified to have potential for functional improvements are often transferred...

Breast cancer is the most common cancer among women in Singapore with age-standardised incidence rates increasing markedly from 26.8 to 38.7 per 100 000 per year over the last decade. While many recognised risk factors exist for the development of breast cancer such as demographic factors (personal and family...

Lupus nephritis is a common manifestation of lupus associated with significant morbidity and mortality. The use of cytotoxic agents has resulted in improved renal outcomes but is associated with considerable morbidity, and their role in the management of lupus nephritis is not universally accepted. This article is available only as...

Retinopathy of prematurity (ROP), which could lead to visual impairment and blindness, is a recognised serious morbidity amongst surviving premature infants. The inverse relationship between the risk of this disease with birth weight and gestational age had been well-documented, in particular, in infants with birth weight ≤1500 g (very...

A 53-year-old man with a history of hypertension and asymptomatic Wolff-Parkinson-White syndrome was admitted to the hospital for an elective uvulopalatopharyngoplasty, tonsillectomy and bilateral functional endoscopic sinus surgery for mild obstructive sleep apnoea and chronic sinusitis respectively. He weighed 109 kg, all his four upper incisors were missing and...

Western literature reports a very high incidence of deep vein thrombosis in its population especially after orthopaedic surgery. In total knee replacement without prophylaxis, its incidence is quoted between 46% and 84% in various studies. This article is available only as a PDF. Please click on “Download PDF” on top...

Voiding dysfunction is a relatively common problem in hospitalised older patients. Up to one-third of hospitalised elderly were reported to have post-void residual urine volume (PRUV) of more than 50 mL. This article is available only as a PDF. Please click on “Download PDF” on top to view the full...

Despite intensive therapeutic efforts, both the incidence and mortality of gastrointestinal complications after cardiac surgery employing cardiopulmonary bypass (CPB) have not decreased during the last two decades. Gastric bleeding, ischaemic bowel disease, gallbladder disease, and pancreatitis are reportedly the most common complications. This article is available only as a PDF....

Bladder carcinoma is the tenth most common cancer affecting men in Singapore. It is more common in men with an age-standardised incidence rate of 6.9 per 100,000 per year for men and 1.7 per 100,000 per year for women in Singapore. This article is available only as a PDF. Please...

Deep vein thrombosis (DVT), and its acute complication–pulmonary embolism (PE), is one of the most important preventable causes of death in hospital patients. It also contributes to significant morbidity in terms of post-phleblitic syndrome and chronic venous ulcers. This article is available only as a PDF. Please click on “Download...

One of the significant milestones in the perinatal care in Singapore is the birth of the Perinatal Society of Singapore in March 1989. This signaled the beginning of increased collaboration between the obstetricians and neonatologists in the management of high-risk pregnancies through multidisciplinary birth defect clinics and high-risk perinatal...

The most common causes of morbidity in adolescence often have behavioural or social determinants, and can have enormous social and economic consequences for adolescent and future adult health and well being. Adolescent substance use and abuse is an example of this. This article is available only as a PDF. Please...

The heart is difficult to image because of its complex wall motion and variability of the cardiac cycle. Recent advances in 16 and 64-slice computed tomography (CT) technology such as thin detector collimation and fast gantry rotation allow the heart to be scanned in a single breath-hold. This article is...

Hospitalisation is a stressful event for the older person. The physiological changes associated with ageing, such as decreased muscle strength and aerobic activity, reduced bone density, altered appetite and tendency towards urinary incontinence, predispose older patients to complications during hospitalisation. Studies have shown that about one-third of older persons...

The first case of human immunodeficiency virus (HIV) infection was detected in Singapore on 16May 1985. The number of newly diagnosed HIV/acquired immuno-deficiency virus syndrome (AIDS) infections has been increasing since 1985, and a total of 1599 cases were detected as of December 2001. In a known cohort of...

In the last few years, hundreds of papers exploring the issue of postoperative nausea and vomiting (PONV) have been published. It has been estimated that the overall incidence of PONV for all surgeries and patient populations is between 25% and 30%, with severe, intractable PONV estimated to occur in...

Coronary artery disease (CAD) is the leading cause of mortality following ischaemic stroke. The annual risk for myocardial infarction following ischaemic stroke is approximately 2.2%. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

In order to commit to their mission and placement requirement efficiently and effectively, policy-makers need to decide which types of students their training units should recruit, what type of curriculum they should design and what kinds of support mechanisms they should implement. This article is available only as a PDF....

Laparoscopic cholecystectomy has become a routine surgical procedure in general surgical units all over the world. Its implementation has expanded dramatically and is considered a feasible and safe approach even for acute cholecystitis.1,2 Laparoscopic management of acute cholecystitis may still be associated with increased risks of complications such as...

Cardiovascular complications account for the highest rate of morbidity and mortality in patients with diabetes mellitus (DM), type 1 and type 2, respectively. The Copenhagen City Heart Study, carried out in 13,105 subjects followed up prospectively for 20 years, reported that in patients with type 2 DM, the risk...

Peripheral arterial disease (PAD) is a significant complication of diabetes mellitus and accounts for the majority of amputations among these patients with diabetes. In addition, PAD is a manifestation of systemic atherosclerosis and is associated with increased risk of death and ischaemic events. This article is available only as a...

Urinary tract infection (UTI) is one of the most common types of nosocomial infections encountered in the inpatient settings including intensive care unit (ICU). Amongst patients admitted to ICU, studies have revealed the incidence of nosocomial UTIs to range from 9% to 29%. This article is available only as a...

The first cases of infection with a novel influenza A (H1N1) strain were reported in 6 cases in California and 2 cases in Texas in the United States in late April 2009. This was linked to outbreaks of influenza in Mexico, which included reports of large numbers of cases...

Obesity is a condition characterised by an excess of body fats. According to the World Health Organization (WHO), there were about 1.6 billion overweight adults aged 15 years and above and at least 400 million adults worldwide in 2005. Obesity poses a serious health burden as it is associated...

Non-alcoholic fatty liver disease (NAFLD) is increasing recognised as one of the most important causes of chronic liver disease in Western countries. It encompasses a spectrum of diseases ranging from simple hepatic steatosis to non-alcoholic steatohepatitis (NASH). Hepatic steatosis is a common clinical and histological finding and it is...

According to the National Health Survey, the percentage of Singapore residents with diabetes mellitus (DM) aged between 18 and 69 years has risen from 8.2% in 2004 to 11.3% in 2010. DM can lead to a myriad of long-term health complications such as coronary heart disease, kidney failure and...